Heilä H, Heikkinen M E, Isometsä E T, Henriksson M M, Marttunen M J, Lönnqvist J K
National Public Health Institute, Department of Mental Health and Alcohol Research, Helsinki, Finland.
Schizophr Bull. 1999;25(3):519-31. doi: 10.1093/oxfordjournals.schbul.a033398.
Adverse life events are an established risk factor in completed suicide. However, few studies have examined life events and suicide in schizophrenia. We investigated and compared schizophrenia suicide victims and age- and sex-matched victims without schizophrenia as part of a psychological autopsy study of all suicides in Finland over a 12-month period. Recent life events were examined retrospectively by interviewing next of kin using a structured life event questionnaire. Overall, nearly half (46%) the schizophrenia subjects had had adverse life events before suicide, significantly less than the nonschizophrenia subjects (83%). In both groups, however, suicide was preceded by life events independent of the victims' own behavior, such as death of a close person or illness in the family. Life events overall were more common among schizophrenia outpatients (52%) than inpatients (22%), and the association of life events with suicide was clearest among a subgroup of outpatients in residual phase who had used neuroleptic medication regularly. Overall, the prevalence of recent adverse life events varied between clinical subgroups of victims with schizophrenia, which may have implications for suicide prevention.
不良生活事件是导致自杀身亡的一个公认风险因素。然而,很少有研究探讨精神分裂症患者的生活事件与自杀情况。作为对芬兰12个月内所有自杀案例进行的心理解剖研究的一部分,我们调查并比较了精神分裂症自杀受害者以及年龄和性别匹配的非精神分裂症受害者。通过使用结构化生活事件问卷对其近亲进行访谈,回顾性地研究近期生活事件。总体而言,近一半(46%)的精神分裂症患者在自杀前经历过不良生活事件,显著少于非精神分裂症患者(83%)。然而,在两组中,自杀前都出现了与受害者自身行为无关的生活事件,比如亲密的人去世或家人患病。总体而言,生活事件在精神分裂症门诊患者(52%)中比住院患者(22%)中更为常见,并且在定期使用抗精神病药物的残留期门诊患者亚组中,生活事件与自杀之间的关联最为明显。总体而言,近期不良生活事件的患病率在患有精神分裂症的受害者临床亚组之间有所不同,这可能对自杀预防具有启示意义。